Dermatology dentally relevant questions Flashcards

1
Q

What type of allergic reaction occurs to natural rubber latex?

A

Type 1 hypersensitivity (immediate - in minutes)

Contact urticaria and anaphylaxis

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2
Q

What dental materials can cause contact dermatitis?

A

Nickel
Epoxy resin
Dental acrylates –> dentures and composites

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3
Q

What type of reaction can occur between the oral mucosa and amalgam?

A

Oral lichenoid reaction

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4
Q

What is the process that drives lichen planus to occur?

A

T-lymphocyte driven chronic autoimmune disease

Multifactorial aetiology - drug induced, amalgam or unidentifiable

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5
Q

What does the skin, mucosa and genitals look like with lichen planus?

A

Skin - papular, purple, itchy lesions on flexor of forearm and shins
Mucosa - white reticulate pattern of keratosis on >1 mucosal surface, plaque like keratosis, desquamative gingivitis
Genitals - reticular keratosis, erythema, ulceration

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6
Q

What treatment is given for lichen planus?

A

Topical/systemic immunosuppressants

No satisfactory treatment

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7
Q

What do the mucosal lesions, systemic symptoms and discoid (Skin) symptoms of lupus erythematous look like?

A

Mucosa - Look like OLP –> White reticulate pattern of keratosis, plaque like keratosis
Systemic - Butterfly like risk across checks
Discoid - Skin lesions/plaques on head and neck, causing severe scars and permanent pigment change

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8
Q

What drugs and virus’ can cause erythema multiforme?

A

Sulfonamides and anticonvulsants (phenytoin and carbmazepine)
HSV and mycoplasma pneumonia

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9
Q

What treatment is given for erythema multiforme?

A

Antiviral
Drug cession
Topical steroid

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10
Q

What are the intraoral signs of pemphigus vulgaris?

A

Epidermis is breaking down causing mucosal erosion, ulceration, blistering
Nikolsky’s sign –> Desquamative gingivitis and pressure =blister

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11
Q

What treatment is given for pemphigus vulgaris?

A

For mild - topical steroids/orbase

For severe - multi-disciplinary

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12
Q

What oral signs are seen in mucous membrane pemphigoid? and what treatment is given for this disease?

A

Mucosal erosion, SP/HP ulceration, desquamative gingivitis, scarring
For mild - topical steroids
For severe - multi-disciplinary

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13
Q

What is BCC? and whats its growth?

A

Carcinoma in the basal cell layer of epidermis
Most common skin cancer
Slow growth, local and lesions don’t metastasise

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14
Q

What are the clinical features of BCC?

A
Pearly 
Telangiectasia
Ulcerated 
Pigmented 
Common in the head and neck area
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15
Q

What treatment is provided for BCC?

A

Excision
Mohs micrographic surgery - high risk lesions
Cautery - low risk/small lesions
Cryotherapy - superficial BCC
Non-surgical: topical, radiotherapy, VISMODEGIB (oral drug inhibiting hedgehog signally pathway, which drives BCC)

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16
Q

What is SCC?

A

Malignant tumour of skin keratinocytes, growing more rapidly than BCC

17
Q

What are the clinical features of SCC?

A

Hyperkeratotic
Sometimes ulcerated and painful
Not pearly/telangiectasia

18
Q

What is the treatment provided for SCC?

A
Excision 
Cautery 
Cryotherapy 
LN dissection 
Adjuvant radiotherapy 
Chemotherapy 
Immunotherapy
19
Q

What are the ABCDEs of malignant melanoma?

A

Asymmetry - whereas moles are symmetrical
Border irregularity - whereas moles smooth and even
Colour variation - usually 3+ colours, whereas moles have 1-2 colours (red/brown)
Diameter - >6mm
Evolving - constant unstable change

20
Q

What is the treatment provided for malignant melanoma?

A
Complicated and aggressive and high mortality 
Surgery - most common 
LN dissection - stage 3 
Immunotherapy - stage 4
Targeted drug treatment 
Radio and chemo - rare for cure
21
Q

What does pigment depend on?

A

No. of melanocytes and amount of melanin they produce

22
Q

What causes internal pigmentation?

A
Race
Addison's disease 
ACTH-producing hormones 
Pregnancy pigmentation 
Drug induced = anti-malarial's
23
Q

What oral manifestation occurs with intake of nicrorandil?

A

(K channel activator)
Oral/skin ulcers
Managed by decreasing dose

24
Q

What oral manifestation occurs with intake of oxybutynin?

A

Lichenoid skin reaction, hard to distinguish from OLP

25
Q

What oral manifestation occurs with intake of captopril?

A

(ACEI)

May induce pemphigus vulgaris

26
Q

What dental materials may cause burning mouth syndrome?

A

Mainly metals, activators, methacrylates